What is an Advance Directive?

July 13, 2020

An advance directive is a document by which a person makes provision for health care decisions in the event that, in the future, he/she becomes unable to make those decisions.

There are two main types of advance directive — the “Living Will” and “Durable Power of Attorney for Health Care.” 


It is a signed, witnessed (or notarized) document called a “declaration” or “directive.” Most declarations instruct an attending physician to withhold or withdraw medical interventions from its signer if he/she is in a terminal condition and is unable to make decisions about medical treatment.

Since an attending physician who may be unfamiliar with the signer’s wishes and values has the power and authority to carry out the signer’s directive, certain terms contained in the document may be interpreted by the physician in a manner that was not intended by the signer.

Family members and others who are familiar with the signer’s values and wishes have no legal standing to interpret the meaning of the directive.


A Durable Power of Attorney for Health Care is a signed, witnessed (or notarized) document in which the signer designates an agent to make health care decisions if the signer is temporarily or permanently unable to make such decisions.

Unlike most Living Wills, the Durable Power of Attorney for Health Care does not require that the signer have a terminal condition.

An agent must be chosen with great care since the agent will have great power and authority to make decisions about whether health care will be provided, withheld or withdrawn from the signer.

It is extremely important that the signer carefully discuss his/her values, wishes and instructions with the agent before and at the time the document is signed. 


A combination advance directive is a signed, witnessed (or notarized) document which contains specific written directions that are to be followed by a named agent.

Since it is not possible to predict all circumstances that may be faced in the future or to cover all possible interventions, specific directions may severely limit the discretion and flexibility that the agent needs and may restrict the agent’s authority in a way the signer did not intend.

Specific written directions may not be altered through discussions between the signer and the agent. Any changes necessitate a new document to reflect nuances or changed directions.

It is important that all adults consider who will make medical decisions for them if they are temporarily or permanently unable to make them for themselves.

Unless a person has an advance directive, many health care providers and institutions will make critical decisions for him/her or a court may appoint a guardian who is unfamiliar with the person’s values and wishes.

We encourage you to download the PDF below this article for more information about North Carolina's standards for Advance Directives.

If Piedmont Crossing can be of assistance, please reach out to the Social Services Department at 336-472-2017.

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